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Kara Badyrka, Community Medical Center chief development officer, shows toys available in two special rooms meant to make the hospital less scary for autistic children.

It is a tricky disorder, one that cannot be diagnosed with a blood test or a brain scan, nor cured with a pill.

Signs of autism and related disorders can show up before a child turns 3 and can include an aversion to touch, a lack of eye contact and repetitive behaviors like arm-flapping, spinning and self-injury when upset.

Many autistic children have problems with communicating and show little interest in interacting with others.

Autism, Asperger's syndrome, Rett's syndrome and Childhood Disintegrative Disorder are all part of a spectrum of pervasive developmental disorders that affects social interaction, communication and behavior, according to Scott Myers, M.D., a neurodevelopmental pediatrician at Geisinger Medical Center in Danville.

Experts estimate that one in every 110 children are diagnosed with an autism spectrum disorder, according to the Centers for Disease Control, though no one is sure what causes it.

Dr. Myers said research has uncovered a genetic link in 15 to 20 percent of autism cases. And while medication and various therapies can address some of the symptoms, there is no cure for autism.

Diagnosis

The state Department of Public Welfare estimated that about 20,000 Pennsylvanians had been diagnosed with autism or a related disorder in 2005. The department expected that number to rise to at least 25,000 by 2010 but had no updated numbers available.

Because diagnosing autism and related disorders early is the key to helping a child as much as possible, the American Academy of Pediatrics recommends that pediatricians and family doctors should administer standardized developmental screening tests at each child's 18-month-old checkup and again at the 24-month-old checkup, Dr. Myers said.

Research done by The Commonwealth Medical College students in 2009 and 2010 show that less than one in 10 autistic children was diagnosed during a well-baby visit, and that developmental pediatricians diagnosed an autism spectrum disorder in 58 percent of the cases they studied, according to Olapeju Simoyan, M.D., an assistant professor of family medicine and epidemiology at TCMC.

Based on those findings, TCMC is planning outreach programs to educate doctors and other health care professionals about the screenings and other resources available to help them make a preliminary diagnosis, Dr. Simoyan said.

"Less than half of pediatricians in this area are using the screeners, local research has shown us," said Mary Christine Remick, licensed psychologist and the clinical director at Northeast Regional Center for Autism Spectrum Disorders at Friendship House. "If doctors don't do screeners, there could be a delay in diagnosis."

If pediatricians did use the screeners, 70 percent of autism cases would be picked up and referred appropriately, she added.

Regardless of whether parents or a pediatrician raises concerns about the possibility of autism, the child is usually referred to a specialist for further testing.

Both Dr. Myers and pediatric neurologist Kenneth Lilik, M.D., in Scranton are among the local doctors who work with children who have been given a preliminary diagnosis of autism. Both doctors said they rely on a number of tests, as well as the child's history and their own observations, to reach a diagnosis.

Treatment

Because autistic children can vary widely in abilities and behavior and can suffer from a variety of symptoms, specialists can help families identify the kinds of treatment their child might need - from speech, occupational and physical therapy to intensive, one-on-one work to develop social, communication and life skills.

Many groups in the area, including Friendship House and Scranton Counseling Center, offer what many experts see as the gold standard in autism therapy - Applied Behavior Analysis.

Put simply, ABA therapy targets specific skills to work on and can be used one-on-one and in group settings.

Among the services offered at Friendship House is an early intensive behavioral center for children as young as 2 to work on language, behavior and other skills.

"Our main goal is to give them a communication system, a way to get their wants and needs met," said Julia Brister, coordinator of early childhood services. "We're making sure they have a good foundation of skills."

At Scranton Counseling Center, autistic children as young as 2 are paired with behavior specialist consultants and therapeutic support staff help develop "pre-language skills and to learn how to learn," said Jerry Nitch, the center's autism services coordinator.

In some cases, therapeutic support staff will accompany school-aged autistic children to the classroom to offer extra help, he said,

When autistic children are old enough to go to school, the Northeastern Educational Intermediate Unit works with families to come up with an educational plan and will review the plan periodically to make sure the child's needs are being met.

As of December, there were a total of 363 autistic students in the school districts served by the NEIU. Some of those students can be placed in traditional classrooms, according to NEIU executive director, Clarence Lamanna, Ed.D. Students who need more attention can attend a program within their school districts or go to the Jefferson School in Dunmore, which offers instruction for kids ages 5 to 21 with special needs, including autism.

At NeuroSensory Center of Eastern Pennsylvania in Kingston, Jeffrey Becker, O.D., and his colleagues work with autistic patients.

Dr. Becker said many autistic patients have trouble with vision and balance, which could contribute to certain behaviors and symptoms. Testing an autistic person's hearing, vision and sense of touch could reveal why certain stimuli - like bright lights and loud noises - are exaggerated or misinterpreted, which gives therapists insight into the treatment necessary to address those specific issues, Dr. Becker said.

In addition, Dr. Becker is also certified in an approach to autism treatment called Defeat Autism Now, which can include recommendations about diet as a way to decrease aggression and increase focus and concentration in certain patients.

Some autistic patients may have food sensitivities, and Dr. Becker said he has had success in about 80 percent of the cases he sees when autistic patients avoid certain foods, including gluten and dairy.

Even with therapy and medication, some people with autism still struggle with symptoms. Many will get upset when their daily routine is disrupted, if they are touched or when they hear loud noises. Others will struggle to communicate, be unable to make eye contact and engage in repetitive behavior, including hitting and injuring themselves.

Doctor's visits and hospital stays can be especially upsetting for autistic children, said Vincent Ross, M.D., director of Community Medical Center's pediatric unit.

And, with the help of some children at Friendship House, Community Medical Center has designed two rooms meant to make the hospital a less scary place for autistic kids.

In addition to beds that are low to the ground and walls painted in khaki and blue, the rooms feature a machine that can be set to a variety of soothing, repetitive sounds like waves crashing on a beach and songbirds.

The rooms also feature a curtain that depicts a lush English garden and a shelf of puzzles, books and games that appeal to autistic children.

"We talked to autism experts locally to see if there was a need for something like this," said Kara Badyrka, CMC's chief development officer. "The answer was a resounding yes."

Contact the writer: enissley@timesshamrock.com

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